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78 Cards in this Set
- Front
- Back
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Cause of HIT
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Abs against heparin-platelet factor 4 complex, which activates platelets, prematurely removing them from circulation --> thrombocytopenia and thrombosis
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Meaning of calcium oxalate crystals in urinary sediment
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Nothing if pt is asymptomatic
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Tests that are contraindicated in setting of acute diverticulitis
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Colonoscopy, sigmoidoscopy, barium enema (all have risk of perforation)
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2 common causes of refractory hypokalemia
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Hypomagnesemia or diuretics
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3 electrolyte abnormalities in chronic alcoholics
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HypoK
HypoMg HypoPhos |
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Ecchymosis on elderly pts extensor surfaces
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Senile purpura
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Cause of senile purpura/ work-up
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Perivascular CT atrophy; benign, no work-up required
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Child w/ healing atopic dermatitis and now umbilicated vesicles over area + fever and adenopathy
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Eczema herpeticum
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Rx for eczema herpeticum
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Acyclovir ASAP
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Pregnant woman with intense pruritus and increased bile acids/ LFTs
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Intrahepatic cholestasis of pregnancy
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How to diagnose/ treat intrahepatic cholestasis of pregnancy
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Diagnosis of exclusion
Ursodeoxycholic acid for pruritus; usually resolves after delivery, but deliver early b/c of fetal risks |
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What LFT is normally increased in prengnacy?
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Alk phos (secreted by placenta)
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Pathogen of concern w/ cat bites
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Pasturella
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Rx for cat bites
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5 days of Augmentin
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What type of virus causes measles?
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Paramyxo
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5 phases of iron intoxication
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GI (from direct mucosal damage): N/V, hematemesis
Latent (asymptomatic) Shock/metabolic acidosis Hepatotoxicity Bowel obstruction from mucosal scarring (several weeks) |
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Pathophys of SSSS
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Exfoliative toxin targets desmoglein 1 (which is responsible for keratinocyte adhesion in epidermis)
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Rx for SSSS
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Eliminate focus of infection w/ anti-staph Abx and wound care
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Most common cause of erythema migrans
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Herpex simplex virus
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Erythematous patch on cheek that progresses to indurated shiny plaque (raised, sharply demarcated) + streaking and LAD
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Erysipelas
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Pathogen that causes erysipelas and Rx
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Strep: penicillin
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Histopathy of liver in Reye's syndrome
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Extensive fatty vacuolization w/o inflammation
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Rx for Reye's
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Glucose w/ FFP and mannitol to decrease cerebral edema
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Sequence of neonatal conjunctivitis
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Gonoccal: 2-5 days
Chlamydial: 5-15 days |
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Adolescent w/ nasal obstruction, visible nasal mass, and frequent nosebleeds (epistaxis)
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Junveile angiofibroma
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Concern w/ juvenile angiofibromas?
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Bleed commonly and likely to recur after surgical removal
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Child w/ diarrheal illness followed by GI bleeding, purpura, and HTN
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HUS
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Cause of anemia in HUS
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Microangiopathic hemolytic anemia
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Type 1 hypersensitivty?
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IgE mediated (allergin binds and cross-links two IgE molecules attached to mast cell)
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Example of Type I hypersensitivity (3)?
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Atopy, urticaria, anaphylaxis
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Type II hypersensitivity?
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Antibody-mediated (cytotoxic reactions create antibodies that activate complement)
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Example of Type II hypersensitivity (2)?
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Immune hemolytic anemia; Rh hemolytic disease of the newborn
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Example of Type III hypersensitivity (2)
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Serum sickness, Arthus reaction
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Type IV hypersensitivity
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Cell-mediated/delayed (requires pre-sensitized host)
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Example of Type IV hypersensitivity
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Allergic contact dermatitis (poison ivy)
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Child ingestion w/ abd pain, hematemesis, hypovolemic shock, and metabolic acidosis
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Iron poisoning
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Pt post splenectomy w/ RBCs that have single, round blue inclusions on Wright stain
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Howell-Jolly bodies (nuclear remnants w/in RBCs that are typically removed by the spleen)
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Common cause of PNA in CF
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Pseudomonas
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Rx for pseudomonas
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Aminoglycoside (e.g. tobramycin) and antipseudomonal penicillin (e.g. piperacillin)
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Presentation of lyme arthritis
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After untreated Lyme infection, intermittent inflammatory arthritis
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Why do celiac pts have bone pain, easy bruising, and hyperkeratosis?
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Vitamin deficiencies (D--> osteomalacia, K, and A, respectively)
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What follows the onion skin appearance in Ewin's sarcoma?
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Moth-eaten/ mottled appearance and extension into soft tissue
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Joint pain w/ central lytic bone defect and surrounding sclerosis
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Osteomyelitis (Brodie's abscess)
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Levels of what are elevated in 21-hydroxylase deficiency?
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17-alpha-hydroxyprogesterone
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Rx for tinea corporis
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Topical antifungals, e.g. terbinafine
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Follicular conunctivitis and pannus (neovascularization) formation in cornea
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Trachoma (chalmydia infection)
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Rx for trachoma
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Topical tetracycline or oral azithro
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Risk of trachoma
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Scarring of cornea
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Rx for strep pharyngitis
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Oral penicillin V
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How to diagnose ALL on peripheral smear
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>25% lymphoblasts
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Auer rods indicate
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AML
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How to distinguish iron deficiency and sideroblastic anemia
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Sideroblastic has increased serum iron levels and normal TIBC (vs. low iron levels and high TIBC in iron deficiency)
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Pregnant woman w/ A fib and pulmonary edema may indicate
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Mitral stenosis
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FH of SCD and syncopal episode + hearing loss
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Long QT syndrome
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Best Rx for long QT syndrome
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Beta blocker
If symptomatic, add a pacemaker |
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Bullous myringitis is most often associated w/ what pathogen?
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Mycoplasma
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2 wks after Abx w/ fever, urticaria, and arthralgias
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Serum sickness-like drug reactions
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Most common cause of aplastic anemia
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Congenital (e.g. Fanconi anemia): AR or X-linked
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Continued ear drainage despite Abx + granulation tissue and skin debris in the middle ear
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Cholesteatoma
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Complications of cholesteatomas (4)
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Hearing loss, CN palsies, vertigo, abscess/meningitis
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Plumber w/ dyspnea w/o cough + crackles, clubbing, pulm fibrosis, and new lung mass
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Asbestosis --> bronchogenic carcinoma
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Most common cancer associated with asbestosis
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Bronchogenic carcinoma (mesothelioma also related)
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Rx for malignant otitis externa
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Coverage for pseudomonas, e.g. ciprofloxacin
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Side effects of MTX
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Macrocytic anemia (or pancytopenia), rash, hepatotoxicity, ILD, alopecia
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Rx for dyspnea from cardiogenic pulmonary edema
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Nitroglycerin
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Most common cause of hereditary angioedema
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C1 inhibitor deficiency --> elevated C2b and bradykinin, which produce edema
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Most common acquired cause of angioedema
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ACE inhibitor use --> C1 inhibitor dysfunction/ destruction
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Difficulty hearing in an HIV pt w/ a dull/hypomobile TM
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Serous (non-infectious) otitis media (auditory tube dysfunction due to HIV lymphadenopathy or obstructing lymphoma)
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Biopsy findings in ischemic colitis
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Epithelial necrosis
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Biopsy findings in IBD
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Neutrophilic cryptitis (transmural w/ Crohn's, mucosal w/ UC)
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Risk of metformin in a pt with renal failure
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Lactic acidosis
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Causes of an exudative pleural effusion (5)
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Infectious (PNA and TB), malignancy, PE, CT disease, and iatrogenic
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What does a positive FISH oncogene amplification/ immunohistochemical staining indicate for breast cancer patients?
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Her2+, so can be treated w/ trastuzumab (and better response to anthracycline chemo)
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Best Abx for infectious diarrhea
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Ciprofloxacin
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Rx for giardiasis
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Metronidazole
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Path associated w/ analgesic nephropathy (2)
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Papillary necrosis and chronic tubulointerstitial nephritis
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Work-up of a diastolic murmur in a young healthy pt
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Echo (same w/ continuous murmurs and loud systolic murmurs)
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Which murmurs need no work-up?
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Midsystolic soft murmurs (grade I or II)
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